Thank you for booking an appointment with The Veterinary Behavior Center!

Our team is committed to helping you and your pet have a happier and healthier life together. Here you will find important information about working with us and a patient questionnaire. All information provided on these forms is strictly confidential.

We will reach out to your primary care veterinarian directly for medical records.  

If you have scheduled an appointment for more than one pet in your household, please fill out a form for each pet.

Please complete this paperwork at least 3 days before your appointment.

Additional information about our Center, including your financial investment, can be found at www.vetbehaviorcenter.com (or feel free to email or text us). Please let us know if you have any questions in the time leading up to your appointment.

 We look forward to meeting you and your pet!

 

- The Veterinary Behavior Center team

This program is designed for "cocktail callibration" so your dog or cat can get back into their veterinarian for medical care without the stress they have experienced before. 

• The initial doctor visit will help determine what is safe and what should be tried.
• The nurses will design trials for you and lay them out in order on your live excel document.
• You perform the tests at home.
• When you need more trials or are ready for the next step you schedule a virtual appointment with the nurses.
• When you think you have landed on a successful protocol, we do a Protocol Assessment appointment in the clinic to see how well it works.  If successful, we send you back to your vet to give it a whirl there.  If not, we cycle back for more trials and repeat.

This program is designed for clients who are interested in determining the protocol at a relatively rapid pace.  To get the most out of it, you are committing to timely trials, accurate logging and frequent touchpoints with the team.  We tweak and adjust along the way as we see how your pet responds to get a functional plan.

 

STATEMENT OF MUTUAL UNDERSTANDING

 

Thank you for seeking out the services of The Veterinary Behavior Center, LLC. Living with behavioral disorders in pets can be very stressful, and we are honored that you have trusted us to help you and your family.

 

Reasonable expectations are important when treating behavioral problems. While in some cases we are able to treat elements of a behavioral condition relatively rapidly, the majority of behavioral improvement occurs over time. Behavior change is a process. Allow us to lead you through this process and most pets can show improvements. Your participation in this process, and consistent follow through, is essential for success. While improvements are common with many behavior problems, most behavior problems are not completely curable. For instance, if your pet is growling, snarling, snapping, or biting, while we may be able to decrease the frequency and intensity of these behaviors, it is likely that, even with treatment, this behavior will occur at some point to some degree in the future. Our goal is to help you decrease the problem behavior to a level that at the very least you can comfortably live with and that maximizes your pet's quality of life. Because each pet is an individual, there can be no guarantee on the results of treatment.

 

You could be held legally and financially responsible for any injuries that your pet causes, and you alone are responsible for avoiding situations that could result in injury. By signing this form The Veterinary Behavior Center, LLC, Dr. Ariel Fagen, or any other person employed by or affiliated with The Veterinary Behavior Center, LLC will not be held responsible for any injuries that may happen to you, other people, other animals, or your pet during the course of treatment. 

 

Furthermore, you agree to indemnify and hold The Veterinary Behavior Center, LLC, Dr. Ariel Fagen, or any other person employed by or affiliated with The Veterinary Behavior Center, LLC harmless from and against any third-party claims, damages, liabilities, actions, judgments, suits, costs, disbursements, and expenses of any kind of nature, including, without limitation, reasonable fees and disbursements of counsel, that may be imposed on, incurred by or asserted or awarded against The Veterinary Behavior Center, LLC, Dr. Ariel Fagen, or any other person employed by or affiliated with The Veterinary Behavior Center, LLC in connection with the treatment of your pet.

 

By signing below you acknowledge the above information. You are the owner(s) of the animal(s) seeking treatment from The Veterinary Behavior Center, LLC. You acknowledge the risks inherent in owning an animal and accept the liability associated with it. You understand that all fees are to be paid at time of service and you accept full responsibility for fees incurred at The Veterinary Behavior Center, LLC during the diagnosis and treatment of your animal.

 

Thank you for partnering with us in the care of your pet. In order to protect everyone’s time and help as many patients as we can, we have enacted this cancellation policy. Once you have scheduled an appointment with us it means that we have reserved time in our schedule exclusively for you and your pet. Rebooking these slots after late cancellations can be difficult and there are many patients in our community that are in need of our care.  

 

The Prep Program is non-refundable and we do not pro-rate for partial use.

 
For your initial doctor visit, we have a 5-calendar day Cancellation Window and a 24-hr Late Cancellation window. How we process payments for cancellations/reschedules will vary depending on whether you do so prior to the 5-day window, between 24 hour and 5 days, or within less than 24 hours/day of. For clarity, here is the preceding day by which we must be informed of a reschedule/cancellation to be considered prior to the 5-day Cancellation Window.  
 

5-day Cancellation Window Chart 

Appointment Day	Monday	Tuesday	Wednesday	Thursday	Friday
Cancel by 11:59pm on this preceding day to avoid cancellation fees	Wednesday	Thursday	Friday	Saturday	Sunday

For your inital doctor appointment with us: 

50% of the Prep Program fee is due at time of booking and you are required to save a card on file. 

For those guardians who are unable or unwilling to save a card on file, 100% payment of the Program fee will be due at time of scheduling. 

If a cancellation or reschedule is required, the following policy applies: 

• Prior to the 5-day cancellation window: Reschedules do not incur any penalty - the initial financial investment can be applied to the rescheduled appointment.  Cancellations are fully refundable minus a $20 processing fee OR the financial investment can be held on file and applied to future services within 6 months with no processing fee deducted.   
• Within the 5-day Cancellation Window: Half of the 50% fee that was paid, so 25% of the full fee, is held as a cancellation fee. Another 25% would be required to schedule another appointment.  
• Late Cancellation less than 24 hours before the appointment or a No Show: The full 50% of the Program Fee is held as a cancellation fee. Another 50% or a card on file would be required to schedule another initial doctor appointment.  

 
For all nurse appointments: 

• Reschedules allowed up to 24 hours before the appointment at no charge. 
• Late cancellation less than 24 hours before the appointment or No Show: a $20 processing fee is incurred.  

 
Additional information: 

• All charged out fees are non-refundable
• No refunds are processed for services rendered WITH NO EXCEPTIONS.
• Reimbursements are always charged the $20 processing fee. 

Summary chart: 
 

	Financial Investment at Time of Scheduling	Cancellation Prior to 5-day Window	Cancellation within 5-day Window	Late Cancellation Less than 24 Hours or No Show
Initial Doctor's Appointment	50% pre-payment due at time of scheduling, other 50% charged out at the appointment	Reschedules at no charge; For cancellation, we can refund the 50% pre-payment minus a $20 processing fee OR hold the fee on file for any future service (within 6 months) with no penalty	25% of total fee held as a cancellation fee; another 25% or card on file required to reschedule	50% of total fee is charged out; another 50% or card on file required to reschedule
All subsequent appointments	Fee already paid with the program	Reschedules and cancellations at no charge	Reschedules and cancellations at no charge	$20 processing fee charged

 
 
If you need to cancel or reschedule an appointment, please do so by contacting us as soon as possible.  Leave a message if we do not pick up.   
 
 
Excessive Late Cancellations Policy 
 
We understand things come up that are sometimes out of our control and want to be as flexible as we can to accommodate these life things.  However, a pattern of late cancellations impacts our ability to care for you, your pet and our other patients.  If the team observes a pattern of late cancellation we will let you know its causing a problem for us.  If it persists, this may be grounds for early dismissal from the program.  Please be mindful of giving us as much advanced notice as possible if a reschedule or cancellation is required.  
 
Late Arrival Policy 
 
We are able to accommodate late arrivals to the appointment up to 5 minutes from the appointment start time.  Understand that we will only be able to utilize our scheduled time that has been reserved and that your appointment time, and the content covered, will be truncated to accommodate your late arrival.  Our providers will do the best they can with the time remaining to make forward progress with the case.  All late arrivals are charged the regular appointment fee as the appointment was scheduled – appointments are not pro-rated based on time used.  After the 5-minute mark, it is at the discretion of the provider whether we can still accommodate the appointment or if we need to reschedule and the late cancellation policies will apply.  
 

For Your Security

All card information is stored directly with our payment processor and undergoes their rigorous privacy protection standards that are PCI Level 1 Data Security Standards compliant.  The Veterinary Behavior Center keeps a token of your card linking the token to their stored information. This means none of our employees have access to actual card information (beyond the last four digits and card type) and protects you against any data breaches of our system.  A hacker would have to hack their highly secure system to reach your card info, not ours.  

 

Alternative Forms of Payment

For any given payment, you may elect to use an alternative form of payment such as cash, ACH transfer or check.  Simply provide payment at time of service and your card on file will not be charged.  We cannot accept alternative forms of payment after the fact for services rendered. 

 

By signing here, you agree to our Cancellation and Card On File Policy, Excessive Cancellation Policy and Late Arrival Policy.  You consent to having your card stored on file to make use of our services or that 100% pre-payment is required with refunds processed only in accordance with the above policy.  You consent to the processing fees, cancellation fees and late cancellation fees that may need to be charged as outlined above.  You understand that all charges for services rendered are non-refundable.  You understand that you may elect to discontinue having your card on file at any time by requesting we delete the card token.  You understand that we aim to be transparent with our billing and that current prices, statements and invoices for all services are always available upon request.  You understand that this policy applies until otherwise informed. 

The Veterinary Behavior Center, LLC utilizes telehealth services as a platform to provide treatment to our patients at a distance. The veterinarian assumes responsibility for making medical judgements and providing recommendations accordingly. Through our telehealth services we are able to perform and assess video/live stream based body language and behavioral assessment, comprehensive intake interview, and review of patient medical records and previous diagnostics. We are able to make diagnoses, recommend diagnostics, determine prognosis, prescribe, engage in client education, assist with administrative support, and develop and administer full treatment plans. The client understands while there are inherent limitations to telehealth services, including inability to perform physical exams, in person behavioral assessment and undertake certain diagnostics, the veterinarian is making medical judgments to the best of their ability with the provided information and will inform the client on any limitations and additional diagnostics or in-person evaluation needed for best quality of care. The client accepts such recommendations and agrees to follow them to the same extent they would any recommendations received via in person consultation. The veterinarian determines the appropriateness of telehealth services based on the individual case and telehealth services may be declined at any time by the veterinarian if it is determined to not be in the best interest of the patient at the veterinarian's sole discretion. The client may decline telehealth services at any time if they choose. To perform telehealth services, clients and patients must be located in the State of Colorado and must be seen in-person at the time of establishing an initial veterinarian-client-patient relationship and at minimum once yearly. By signing this form you consent that you are located in Colorado and understand and agree to how telehealth is used in our practice.

 

**All patients being managed by one of our doctors that have not been seen in person within the past year will be required to do an in-person evaluation in order to continue treatment. This ensures that we abide by the Veterinary Practice Act and is not negotiable.**

The Veterinary Behavior Center, LLC seeks permission to use any recordings, photos and videos for the purposes of diagnosis, treatment planning, and monitoring as well as for educational and marketing purposes, including but not limited to lectures, webinars, presentations, printed materials, and social media. When used for view in the public, no identifying information will be revealed.

 

Medications may be discussed or recommended in the course of treatment of behavioral problems. Many of the medications prescribed in veterinary behavior have not been approved by the FDA (Food and Drug Administration) for use in all or any animal species for all or any behavior problems. Thus, their use may be considered “off label”. This is a legal, common, and well-accepted practice for veterinarians to prescribe medications in this manner. The side effects of off label usage have not been fully studied and regardless, any medication may have unexpected side effects. Not all pets will require the use of medications as part of their treatment, but we want you to be aware of this information in advance. We will make every effort to inform you of potential benefits and side effects of any medications recommended to the extent known. However, you should be aware that different pets may react differently to different medications. We welcome any questions about the use of medications in your pet’s treatment plan. By signing this form you acknowledge that you have received and read this information. Signing this form in no way obligates you to using medications in the treatment of your pet.